1376719732 NPI number — SUNNY LAKES HOME HEALTH CARE INC

Table of content: (NPI 1376719732)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376719732 NPI number — SUNNY LAKES HOME HEALTH CARE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SUNNY LAKES HOME HEALTH CARE INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1376719732
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/21/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5979 NW 151ST ST
Provider Second Line Business Mailing Address:
SUITE 236
Provider Business Mailing Address City Name:
MIAMI LAKES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33014-2427
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-824-9920
Provider Business Mailing Address Fax Number:
305-818-6609

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5979 NW 151ST ST
Provider Second Line Business Practice Location Address:
SUITE 236
Provider Business Practice Location Address City Name:
MIAMI LAKES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33014-2427
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-824-9920
Provider Business Practice Location Address Fax Number:
305-818-6609
Provider Enumeration Date:
05/06/2008

Additional Information

Authorized Official

Authorized Official Last Name:
PRATS
Authorized Official First Name:
LISSETTE
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
305-824-9920

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: PENDING MEDICARE# . This is a "PENDING MEDICARE#" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com